Earlier this month, a West Africa-based cameraman by the name of Ashoka Mukpo contracted Ebola while shooting for NBC News in Liberia. Mukpo had been hired to accompany the network’s chief medical editor, Nancy Snyderman, as she reported on the deadly virus, which, according to CDC reporting, has already claimed at least 4,033 lives. (According to the CDC, there had been 4656 “laboratory-confirmed cases” as of October 10, resulting in 4,033 deaths. The CDC also estimates that new Ebola cases could soar to 10,000 a week in the near future.)
When it became known that Mukpo had been infected, he was sent to Nebraska for treatment, and the rest of the NBC crew, who had been working in close proximity to him, agreed to enter voluntary isolation for a period of a few week’s time. (Those infected with Ebola typically begin to show symptoms within 21 days.) In spite of this quarantine agreement, however, it was reported yesterday that Snyderman was seen in a car near her Princeton, New Jersey home, waiting for her companion to bring food to her from a local restaurant. Snyderman, to her credit, did not dispute the charge, and has since been ordered into mandatory quarantine. Last night, NBC Nightly News anchor Brian Williams read a statement from Snyderman, saying that she was sorry for what she’d done. Here’s a clip:
“While under voluntary quarantine guidelines, which called for our team to avoid public contact for 21 days, members of our group violated those guidelines and understand that our quarantine is now mandatory until 21 days have passed… We remain healthy and our temperatures are normal. As a health professional I know that we have no symptoms and pose no risk to the public, but I am deeply sorry for the concerns this episode caused.”
With all due respect to Nancy Snyderman, I hope that she loses her medical license immediately, as well as the ability to ever again walk onto the set of a network news soundstage as a respected representative of the medical community. The thought that she could so cavalierly go out for a sandwich after having given her word to stay isolated, and just days after we’d seen our first death from Ebola in this country, absolutely sickens me, and you can be sure that I will write to any future employers that she may have, reminding them not only of her serious lapse of judgement, but of the way she attempted to shift the blame after the fact, refusing to take any responsibility for her actions, saying instead that “members of (her) group” violated “guidelines.” And, just to be clear, it wasn’t “members of her group” that violated protocol. It was her. And these weren’t “guidelines” that Snyderman violated as she went out shopping with her male companion. Public health officials didn’t suggest to her that she stay away from people. They made her promise to stay isolated for 21 days from the point of contact, to ensure that the virulent disease, if she did have it, wouldn’t get a foothold in the United States.
Speaking of the 21-day incubation period, how dare she say, “As a health professional I know that we have no symptoms and pose no risk to the public,” knowing full well that even those infected don’t present with symptoms for several weeks. She should be fired for this statement alone.
Yes, I know that she likely isn’t infected, but that’s not the point. The point is that she thought that she knew better than public health professionals because she’s a wealthy, successful surgeon turned celebrity. She thought that the rules didn’t apply to her. And she knowingly put lives at risk as a result… And I find that sickening, especially when so many truly heroic doctors are giving their lives in Africa right now to stop the spread of this deadly virus. (It’s being reported today that 16 members of Doctors Without Border have been infected with Ebola, 9 of whom have already died.)
Two things you can do today… Donate to Doctors Without Borders and write to the American Medical Association, asking them to open an inquiry into Snyderman’s flagrant disregard for public health.
[edit: For what it’s worth, yes, I know that people aren’t contagious until such point that they become symptomatic. Public health protocol, however, is in place so that people who may have the virus don’t become symptomatic while in public. So, just to be clear, I did not think that Snyderman was “infecting” people in Princeton by being out of her home. As I point out in the post, I realize it’s unlikely that she has the virus. And, even if she did, it’s highly unlikely that she’d become symptomatic while running errands this past weekend. My point, however, is that she should know better. The protocol may be inconvenient, but it’s necessary.]
39 Comments
While it is troubling that she didn’t do what she said she’d do, I’m not sure that she can really be accused of doing anything worse than that.
If she had become feverish, she could have gone immediately to a doctor, who would have tested her for Ebola.
While enforced quarantines are appropriate for people who might have had direct contact with Ebola patients, is there any evidence that this person did? If not, then while it would make sense from a preventative stand point to isolate her, the risk of disease is likely very low and a wait and see strategy might be more appropriate.
America is just going to have to deal with the reality that cases will enter the country and there’s not much that can be done about it. However, it also needs to deal with the reality that the conditions which allow this crisis to go on in Sierre Leone and Liberia just don’t exist in the United States. It is very possible the transmission will occur in the US (as in Spain) but the likelihood of sustained transmission is very low and the probability of dying given infection is much lower in the US than in Liberia.
Shit happens. People get sick and they die from a lot of things, but this panic scenario the US is experiencing doesn’t save lives.
So we should feel free to disregard the directions of public health officials, Peter, as long as we’re feeling fine? This opinion of yours surprises me.
When you strip else everything away, Dr. Larson is a Libertarian.
“Snyderman’s now-mandatory quarantine is in effect until 11:59 PM on October 22.”
It’s not as though she was starving and without resources. She has a staff. Any number of people could have brought her food and left it for her. This is about entitlement, and her belief that she doesn’t have to play by the same rules as everyone else.
Ebola is not transmissible until patients are symptomatic. Just to be clear, she posed no threat is she was asymptomatic and we need to all be clear on that. Her statement, which angered you so was accurate: “As a health professional I know that we have no symptoms and pose no risk to the public.”
As a public heath professional, she should have followed the quarantine guidelines. Not so much because she posed a threat, but because people freaking out poses a public health threat as well. On the other hand, if you are going to write about this epidemic, you are also obligated not to propagate misconceptions and feed the flames of fear and anxiety. Because people do stupid unsafe shit when they operate from fear. A public forum requires responsibility.
And so I repeat: EBOLA IS NOT TRANSMISSIBLE UNTIL SYMPTOMS APPEAR. Thank you.
From the CDC (Paragraph 5) :
“People are not contagious during that incubation period; they become contagious only when they start having symptoms.”
http://blogs.cdc.gov/cdcdirector/2014/08/20/the-high-stakes-in-fighting-ebola-leave-one-burning-ember-and-the-epidemic-could-re-ignite/
“So we should feel free to disregard the directions of public health officials, Peter, as long as we’re feeling fine? This opinion of yours surprises me.”
Public health policy, like all policy, while certainly well intentioned, isn’t always reasonable or well thought out. We have a right to be critical, particularly those of us in this particular field.
My opinion is that a wait and see scenario would have been appropriate assuming she did not have direct contact with a symptomatic case. Perhaps she did, I really don’t know but that’s my professional opinion.
Quarantines and travel bans shouldn’t be taken lightly because they can backfire quickly or even become appropriated for goals which have nothing to do with the pathogen in question.
Public health professionals have to strike a balance between what protects the public health and what becomes an infringement on the rights of individuals. It’s not an easy balance to make.
I fail to see how that makes me a Libertarian.
@Jean Henry,
She very well could have started getting a fever while she was sitting there waiting for her soup and sandwich. And therefore could have exposed, at a minimum, whoever else were the “members of her group” that were with her. And anyone else she was in contact with while returning to her “quarantine”
I agree completely with what Jean Henry said.
What bugs me about this case isn’t that she put people in any real danger but that her actions are frightening to people and that is a problem too. That and her sense of false entitlement although I think if we are honest, most of us are willing to break rules sometimes. I am not sure rendering her unemployable would help anything although I have to admit that if some kind of sustained viral campaign were to be mounted against her, I would have a hard time feeling sorry for her since that is exactly the sort of mass lunacy things like a quarantine are supposed to help avoid.
Jean, the point is not to be in public when you turn symptomatic. She was directed by professionals in infectious disease management to stay isolated for 21 days from the time she was in contact with her cameraman. She neglected to do this. Then then lied and misrepresented the facts in order to avoid taking responsibility for her actions.
Jean, do you read the posts? Mark said, “Yes, I know that she likely isn’t infected, but that’s not the point. The point is that she thought that she knew better than public health professionals because she’s a wealthy, successful surgeon turned celebrity.” He wasn’t fear mongering. He wasn’t saying that we should burn down her house with torches because she was in Africa. He said that she should have followed the procedures that were put in place by public health professionals. He never said that she was symptomatic, or a public health threat. As others have pointed out, though, this illness comes on quickly. That’s why she was asked to quarantine herself.
I’m with Peter. As long as you’re able to walk, you should be able to do what you damn well please. If I had the Black Death and wanted to go on a merry-go-round, that’s my fucking business. No one is making you take your kids to the carnival. Total freedom. That’s what makes us great. I have the right to cough in your face if I’m dying of the plague, and you have the right to shoot me in the guts if you don’t like it.
On this issue, I put a hell of a lot more stock in Peter’s opinion than the opinion of anyone else on this blog. He is our local expert. He is labeled as belonging to some “other” community when his EXPERT opinion does not line up with our uninformed opinions?!? Now that is interesting…Fox news probably disagrees with Peter as well…There is a pattern exclusion and close minded responses on this blog and in Ypsilanti in general.
I wanted to draw your attention to this timely piece that we’ve just posted, about what history can teach us about the Ebola outbreak. It features our Dr. Howard Markel, who studies the history of epidemics and has made many media appearances in recent days. Find it at http://umhealth.me/histeb
No one is disagreeing with Peter on the threat of Ebola. What people have an issue with is that he seems alright with people choosing to disregard the directions of public health professionals. As a public health professional himself, one would think he’d encourage people to follow guidelines.
Maybe it’s time people did get a little freaked out? Maybe it’s time the CDC stops telling people that it’s no big deal. Maybe then the 2nd nurse that was just diagnosed with it yesterday wouldn’t have thought it was ok to get on a flight from Cleveland to Dallas on Monday night (the day before she was diagnosed, who knows when she actually showed symptoms)
Peter says “While enforced quarantines are appropriate for people who might have had direct contact with Ebola patients”.
So why are the nurses and caregivers that treated Duncan in Dallas allowed to get on flights, and just get their temperature checked once a day?
I’m glad to see so many people defending this woman’s rights to get out and grab a sandwich. GOOD FOR HER. GOOD FOR SANDWICHES. I’m glad she’s a doctor. We need more heroes in this country like the police and the people making the hard decisions in congress. The WORST thing you can do in this country is call someone out for being stupid or selfish, Mark. How dare you?
CDC now saying that the 2nd nurse that was diagnosed last night/early today had a temperature of 99.5 BEFORE she boarded the plane in Cleveland.
Glad the CDC keeps telling people it’s no big deal.
I like how this blog is now outraged about everything 100% of the time.
BREAKING NEWS: CDC and Frontier Airlines say second health care worker diagnosed with Ebola flew from Cleveland to Dallas on Monday. CDC and Frontier Airlines are working to reach out to all 132 passengers who flew on Flight 1143 on October 13.
I think we all know it will take at least 30,000 people dying every year from Ebola to get the NVA (National Viral Association) to contribute millions into lobbying congress to defend the rights of quarantine victims to be allowed the Freedom! to buy soup and travel to exotic locations like Cleveland.
Where can I contribute to get a concealed carriers law passed?
As often happens, this conversation bled over to Facebook, where Dr. Larson and I continued to exchange notes like the following.
PETE:
MARK:
Although Ebola is not new, an outbreak of this size and complexity is. Despite claims by public health officials about how you “can” and “cannot” catch this virus, we have already had several surprises — such as healthcare workers who were supposed to be protected, who nevertheless becoming infected.
Given the rapidly-evolving situation, and the (small, but real) potential for a worldwide pandemic, exercising anything other than the maximum precautions — at least until we know more about how this particular variant of the virus spreads, and behaves, is the height of irresponsibility.
Of course individual rights need to be weighed against the collective good — but at this point, the “right” to go out for a latte does NOT outweigh the need to do everything we can to stop a potential public health catastrophe.
And in this case, as a doctor — and a highly visible “TV” doctor, at that — I agree that Snyderman should be held to an even higher standard than an ordinary member of the general public.
The likelihood of sustained transmission is much higher in the densely populated urban environments of the U.S. than in the isolated, remote villages of Nigeria, Sierre Leone, Liberia and Zaire. Let’s hope that the nurse who flew roundtrip from Texas to Ohio wasn’t sneezing and didn’t handle the flight magazines with sweaty hands. The virus can exist for several hours on a hard dry surface and the airplane that she rode on handled 7 additional flights full of people before it was thoroughly decontaminated. Most hospitals in the U.S. can handle several cases that need complete isolation and special protective equipment for all caregivers. How many hospitals in the U.S. are currently equipped to handle a couple hundred cases at once? Pray that this virus doesn’t hit our populated areas before we can fully prepare and stock local hospitals with necessary supplies and equipment. And pray for the panic to be successfully controlled that will be widespread once the military and police start enforcing real quarantines. Pray that Central America doesn’t have an epidemic that would cause the rest of their citizens to flood across our unprotected borders. God help us.
Hey, while we are at it, let’s make flu vaccines mandatory!
The vast majority survive the flu. It’s most often a short-lived minor illness.
“Pray that Central America doesn’t have an epidemic that would cause the rest of their citizens to flood across our unprotected borders.”
i assume you’d be praying for people in central america as well right? for their lives and all. not just for their failure as continental disease carriers. (dead people can’t cross borders!)
“The likelihood of sustained transmission is much higher in the densely populated urban environments of the U.S. than in the isolated, remote villages of Nigeria, Sierre Leone, Liberia and Zaire.”
You do realize that Lagos, Nigeria’s largest city, has an estimated population of 21 million people, right?
Even Libera’s much smaller capital city, Monrovia, has more than a million people.
EOS seems to think that all Africans still live in huts, in remote villages … instead of in large, teaming cities, with tall buildings, expressways, etc.
Prior to the recent outbreak, all the previous Ebola outbreaks have been limited because they occurred in small, remote villages. The epidemic stopped because it ran out of people. This outbreak is different, and because of that, it is critical that our response be appropriate. The CDC’s main focus should be on stopping the spread of disease, not on spreading misinformation in order to prevent widespread fear.
EOS, the vast majority of people who get the flu survive it but because it is so transmittable, more people die because of it. Most of those deaths are preventable with a flu vaccine. Public health guidelines are such that flu vaccines are recommended for most people. This doctor is guilty of bad judgement for violating health guidelines but not more so than when health care providers (or really anyone) fails to get a flu vaccine. Focusing too much on Ebola at the expense of the flu may result in more deaths.
I get it that Ebola is way more scary because if someone gets it, it is so much more lethal. However, let’s not forget that it isn’t a very easily transmittable disease.
Ebola is a hell of a lot easier to transmit when the CDC keeps telling everyone that is exposed to it, to go about their normal lives and travel on commercial flights when they have a fever.
Everything is about to get batter. Obama has appointed an Ebola Czar.
“President Obama named Ron Klain, a former chief of staff to Vice President Joe Biden and also to Vice President Al Gore, as the new Ebola czar to oversee the government’s response to the ongoing crisis. Klain is currently president of Case Holdings and General Counsel of Revolution, an investment group.”
http://washington.cbslocal.com/2014/10/17/obamas-new-ebola-czar-does-not-have-medical-health-care-background/
Too bad we don’t have a Surgeon General: http://www.politicususa.com/2014/10/14/nra-prohibited-surgeon-general-advising-americans-ebola.html
People sitting near nurse with Ebola on flight to Dallas claim not to have been placed in isolation by CDC.
Read more:
http://www.nydailynews.com/news/national/male-strippers-quarantine-flying-ebola-stricken-nurse-article-1.1977644
Dan: too bad we don’t have a President who gives a damn that Americans are dying of Ebola. Too bad we don’t have a CDC that cares more about preventing epidemics than making up phony studies about “gun violence.”
I suppose it’s par for the course for a dying, declining culture that doesn’t even have the will to quarantine AIDS carriers.
Accusations of “raaaaaaaaaaaaaaaacisms” and the American Psychiatric Association rewriting the DSM to include a newly discovered phenomenon called “Ebolaphobia” in 5, 4, 3…
Nancy Snyderman is a hopeless hack. Tonight on her flu virus report she showed several victims who have died from the flu as a reason why everybody should get a flu shot. What she failed to report was that one of the victims whose picture she featured actually died as a result of getting a flu shot. Nice reporting Nancy!!